Objective: To determine whether it is possible to predict the risk of ureteral endometriosis (UE) using a mathematical model based on preoperative findings.
Design: Prospective observational study conducted between January 2017 and April 2020.
Setting: Tertiary-level academic referral center.
Patient(s): Three hundred consecutive women of reproductive age with a diagnosis of posterior deep infiltrating endometriosis (DIE) scheduled for laparoscopic surgery.
Intervention(s): Before surgery, anamnestic data and the severity of endometriosis-related symptoms were evaluated, and all patients underwent a complete gynecological examination. Transvaginal and transabdominal ultrasound were performed to map the endometriotic lesion. Ureteral involvement was surgically and histologically confirmed.
Main outcome measure(s): To select important risk factors for UE and determine a suitable functional form for continuous predictors, we used the multivariable fractional polynomial.
Results: UE was surgically found in 145 women (48.3%). Based on our multivariable polynomial mathematical model, UE was significantly associated with adenomyosis, parametrial involvement, and previous surgery for endometriosis. A posterior DIE nodule with a transverse diameter >1.8 cm was associated with a higher probability of ureteral involvement.
Conclusions: Posterior DIE nodule with a transverse diameter >1.8 cm, adenomyosis, parametrial involvement, and previous surgery for endometriosis appear to be good predictors of UE.
Keywords: Deep infiltrating endometriosis; laparoscopy; ultrasound; ureteral endometriosis.
Copyright © 2021 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.